[Closed] Osteopathy - is it in the same league as homeopathy etc? Talk to me please...

Not in the same league as homeopathy as doesn't really on magic in the same way.
Probably works if you've got back pain, probably not if you've got asthma.

Never been shown to have any effect in proper studies, anecdotally has an effect, I have had it and would do again.

Lots of totally overblown claims for what it can do.

From

[url= http://info.wirral.nhs.uk/document_uploads/evidence-reviews/OsteopathyEvidenceBriefing.pdf ]http://info.wirral.nhs.uk/document_uploads/evidence-reviews/OsteopathyEvidenceBriefing.pdf[/url]

There is very little research on the effectiveness of osteopathy and guidelines appear to be non-existent.
Evidence on the effectiveness of osteopathy could only be sourced for a limited number of conditions; dysmenorrhea, asthma, sub-acute spinal pain and low-back pain.
The research evidence does not appear to support the use of osteopathy for asthma or painful period cramps [3,4].
The evidence does appear to support osteopathy for spinal pain and low-back pain however, but only when given alongside usual care as a complementary therapy.
For spinal pain, osteopathy decreased reported pain and improved mental health outcomes and did so in a cost-effective way, at well below the 30,000 QALY threshold set by NICE [5,6].
For low-back pain, results were more mixed, with one study finding no differences between usual care and usual care plus osteopathy (except a reduction in prescribed NSAIDs) and one study finding significantly improved pain outcomes at short, medium and long-term follow up [7,8].
In light of this and the fact that the DoH’s Musculoskeletal Services Framework [1] recommends that people should have access to a range of non-surgical alternatives to help them deal with joint pain (to include osteopathy), it would seem sensible to offer the therapy to appropriate patients.

So, in summary. Sometimes.

[EDIT - I've had treatment with three different ones, generally helped. A lot of what they did though was similar to sports massage/physio rather than back-clicking]

As above a lot of what osteopaths do seems to be massage.

I've use it a few times and noticed an improvement.

There are overlaps with physio, massage therapy and osteopathy. A lot of it is people trying to find ways to provide physiotherapy without undergoing the training that physios have to go through. If you want the best treatment go to a physio.

I've had several courses of osteopathy over the years for various sports injuries (aftermath of a severely dislocated shoulder, plus numerous strains and bumps). I'd recommend it, in my experience it does work, and a good osteo should be trying to fix the problem in the least amount of sessions (not booking you in for 12 months' of treatment £££).

Not sure where in the country you are, but if you want a recommendation for an osteo 20 miles north of Bristol, I'd be happy to give you the contact details for mine

That NHS study is junk.

That's why people waste months going to physios for back problems and get nowhere - people in the NHS still hardly recommend them.

Strange that BUPA and similar do recognise them as they are interested in getting their patients fixed quickly rather than eating up load of their money.

Case in point - a work colleague's sister did horse dressage but never got in the medals.

A trip to the osteo recognised that she had a tilted pelvis (very common as most people habitually stand with one leg in front of the other and over time...) and straightened her up. Next competition she got a silver as the horse now knew that she wanted to go straight and not turn left.

Check out the before and after on this page:

http://www.cityclinic.co.uk/

Lots of totally overblown claims for what it can do.

Sounds more like a chiropractor...

Mine does chiropody as well. He's a footpath.

If you want the best treatment go to a physio

now you are talking junk - it depends on the problem - what if you need a manipulation - I wouldn't trust a physio to do it.

How much training do physios have - more than 4 years?

Why wouldnt you trust a physio to do a grade 5 manipulation? Manipulations make for good party tricks, but there's not a lot of evidence to suggest that they are good for much more than that.

Physios in Scoltand do a 4 year degree course, then spend a minimum of 2 years as a closely supervised junior physio before taking on any senior roles.

I agree with sbz without a programme of stretching and other exercises to build up the appropriate muscle groups, any manipulations would only have a short term effect.

The real problem is life style and individuals attitudes to their bodies!

That said I'm off to warm up! and do my exercises, including some dancing!

Hope you all enjoy sitting there! looking at your screens 😀

provide physiotherapy without undergoing the training that physios have to go through

so 4 years training for an osteopath as well.

Turner guy - the problem is the lack of real evidence that osteopathy / spinal manipulation does anything.

Depends entirely on the practitioner, from what I see of people who go to them.

There are some who are really really excellent.

There are others who tell everyone they have a tilted pelvis because one leg is shorter than the other - and seem to actively encourage expensive dependency amongst their patients.

We had a local one who managed to carry on practicing despite having been removed from the register by the General Osteopathic council - for reasons which seem rather harder to find out than those for which Drs get struck off...

And don't believe anyone who trashes [i]all[/i] physios... (and I am not a physio or chiro or osteopath).

I can still remember the pleasure when I had my back "unzipped" by an osteopath 10 years ago now. Still do the simple twisting exercises he showed me to keep it flexible and pain free. Best £20 I ever spent.

lack of real evidence that osteopathy / spinal manipulation does anything.

but that would be because most of the time it doesn't actually 'do anything' - it corrects you back to the state you should have been in if you had been sitting correctly, or not always standing with one leg in front of another, or helps straighten your spine back up after a fall on the mountain bike.

There may be loads of good physios, but I also here loads of stories of non-effective physios.

A mate of mine had a hamstring problem - spent about a year seeing various physios, etc - then went to an osteo near London Bridge who fixed him in a couple of sessions.

Nothing to do with manipulation - the guy was a serious runner and knew how to fix the problem. But then so should the physios after all that training...

I had similar story with a rotator cuff issue - physio I went to was down on Bupas list as a shoulder specialist but I didn't get anywhere until I went to an osteo who effectively gave me remedial massage.

Sort of contrasts with SBZs proclaimation that

If you want the best treatment go to a physio

Physio is an active treatment. You need to put the work in if you want to get benefit from it. People who complain that physio didnt work more often than not didn't do what was prescribed for them. I have heard countless stories of people modifying their exercises to give something that "worked" for them.

Any idiot can get pain to go away for a couple of days. Getting it to stay away for longer takes hard work from the patient.

so now you are calling osteopaths 'idiots' ?

An osteo and friend I use locally posts in here, so a little manners from some of you might be nice.

I see David primarily for deep tissue massage and a little spinal manipulation when Ive been foolish hefting stuff about or swinging sledgehammers/shovels too much. I find it very beneficial, and no doubt to a certain degree a physio/sports massage might achieve similar results. Although I do like the crrrrunnchchchchcCLICK!!! I get from Dave which I wouldnt trust a physio to do to me.

Mrs S prefers her sports physio. Horses/courses.

A trip to the osteo recognised that she had a tilted pelvis (very common as most people habitually stand with one leg in front of the other and over time...) and straightened her up. Next competition she got a silver as the horse now knew that she wanted to go straight and not turn left.

The NHS study is junk - but your example is pure scientific FACT!

Turner Guy loves an Osteopath, but she doesn't even notice him...

I love these threads.

Why do people not trust NHS physios?

but your example is pure scientific FACT

dunno about scientific - but it is fact.

Horse osteopaths are also quite common.

I don't know any female osteopaths 🙁

It's chiropractors who are the real quacks, same level as homoeopathy ie claim depression can be treated by cracking your back. Should not be seen on general principle. Osteopaths are more genuine, ymmv on whether they're any good.

Can I hijack slightly to get an opinion on reflexology?
I've been suffering with a virus for he lst 4-5 months, resulting in breathlessness when i do anything more than a fast walk. Doc has said it might take months to shift and just to get absolute rest.
A number of people (only females strangely) have said to get myself to a reflexologist...along the lines of 'they can't cure it, but they they might boost the immune system to help'...
Any thoughts from folks?

ive used osteopaths for years. there are two main options as far as i know.. "cranial" which is tiny movements that seem to do nothing at the time but does work or did for me!! and what i call the click crunch method that is when they use force to move joints etc

but i fell from a great hieght a few years ago and none seem to be able to do anything for me this time round. so ive just started to see a sports masseuse which so far is showing results... so watch this space.
overall i feel that different therapies work for different people so it may be that you need to try a few till you get it right!!

only females strangely

that bastion of rational thought 😉

Can I hijack slightly to get an opinion on reflexology?

I have these magic beans you might be interested in? 😛

[i]Can I hijack slightly to get an opinion on reflexology?
I've been suffering with a virus for he lst 4-5 months, resulting in breathlessness when i do anything more than a fast walk. Doc has said it might take months to shift and just to get absolute rest.
A number of people (only females strangely) have said to get myself to a reflexologist...along the lines of 'they can't cure it, but they they might boost the immune system to help'...
Any thoughts from folks?[/i]

Two thoughts:

1. Use the time you are resting to investigate why reflexology is not going to help.

2. Stop listening to knobbers.

Bit clumsy that fatmax tbh.

Speaking as a physio we tend not to use Grade V manips too much for a number of reasons... they're a great quick fix to get someone moving properly but should only really be used to enable someone better movement upon which they can do their exercises to improve upon what is the underlying problem. But you can use other mobs to much better effect, there's a whole range of less glamorous and non clunking mobs to be done which can be even more effective - look up mulligans and the whole nags / snags stuff.

That way you got non dependent clients, that will hopefully go off and do their exercises and look after themselves rather than keep coming back - in turn saving the NHS cash.

And also on the training front - we do 3 or 4 years (depending on country) but also have a higher qualification for manips - the MACP which is an MSc course in itself.

I think the chiro and osteo have some place but should calm down on their over inflated claims on curing all by doing a bit of clicking.

It's chiropractors who are the real quacks, same level as homoeopathy

agreed - my wife is doing some receptionist work at a chiropractor.

After the initial assessment and manipulation the following sessions with the main guy there consist of him using some sort of pen thing only - 10 minutes and £35 quid, thank you very much.

Some osteopaths just do a manipulation, but the one I go to gives you 45 minutes of remedial massage and general beating up (knotted muscles) and then 15 minutes of manipulations for his £70 quid. He works hard for his money and has to go to see an osteo himself every now and again to fix him up after man-handling all those fat Londoners.

It seems to be the british school of osteopathy that don't do the massage and the british school of osteopathy and naturopathy/british college of osteopathic medicine that do. The massage seems to make the manipulations much more effective.

£70/hr that's a hefty amount of cash. Interesting to see that there's no assessment built in. Are the manipulations just random ones or targetted? If they're targetted how can the be targetted if there's no assessment?

Not sure I can see how a physio is going to be a better manipulator when an osteo spends 4 years studying manipulation and a physio 3-4 years on a wider curriculum.

[i]Not sure I can see how a physio is going to be a better manipulator when an osteo spends 4 years studying manipulation and a physio 3-4 years on a wider curriculum.[/i]

Do want to be manipulated or do you want to get better?

The two are not exclusive, but the whole idea of physios doing all that 'wider curriculum' stuff is to be able to help people, rather than make fancy cracking sounds...

No offence taken and no worries...the response I expected...just trying to use the collective experience of STW in addition to nagging female pals and family that must read too many alternative remedy articles. Happy to be flamed for that tbh

just random ones

yeah. They just run around clicking stuff for the [i]craic[/i]...*

Im going to guess here, but I imagine those that do the massage component first together with the pre treatment chat and positional work are assessing you before making any manipulation decisions. That seems my experience, anyway.

*see what I did there?

What's the big deal about manipulations?

If we're talking about who is best at manipulations my money is squarely on the orthopaedic surgeon.

All you need to do to make a joint crack is to give it a high velocity and high amplitude thrust. There's your 4 year osteo training in a single sentence.

[i]No offence taken and no worries[/i]

I feel bad now, I'm sure your family and your female friends are not 'knobbers', and I apologise for suggesting so.

Reflexology is a bit poo though.

poo reflexes are bad mmkay.

£70/hr that's a hefty amount of cash

not in London it isn't

There will be an assessment based on the patients movement the first time you see an osteo, which may result in a recommendation for x-rays/etc.

Of course once 'corrected' there is then the argument to go to see a good physio for a range of strengthening exercises to sort out to problem long term.

But a lot of people just don't have the time.

I am not saying that they are magic but all the ones I have seen so far have been good to excellent.

anonymouse - Member
Mine does chiropody as well. He's a footpath.

Coincidentaly mine does psychiatry as a sideline, he's a psychopath.

Is it osteopaths that massage the colon to help folk have a jobby?

anonymouse - Member
Mine does chiropody as well. He's a footpath.

Coincidentaly mine does psychiatry as a sideline, he's a psychopath

Mine fixes bikes too, he's a cyclepath.

Is that not uphill gardening?

I thought that was ron jeremy?

All you need to do to make a joint crack is to give it a high velocity and high amplitude thrust

but most osteos don't do that, they use an indirect method to get the release.

Chiros are more direct, generally.

I guess I should have a quick post here...
It's not magic, it is pure mechanics! If a part of the body is out of alignment then the surrounding muscles and ligaments are put under undue stress & strain so predispose that part to injury. We try to reverse this pattern to remove the problems at their root cause. An Ostepath will look at the whole body looking for patterns that may have caused the problem you are experiencing.

"crikey - Member

[i]Not sure I can see how a physio is going to be a better manipulator when an osteo spends 4 years studying manipulation and a physio 3-4 years on a wider curriculum.

Do want to be manipulated or do you want to get better?

The two are not exclusive, but the whole idea of physios doing all that 'wider curriculum' stuff is to be able to help people, rather than make fancy cracking sounds..."[/i]

Physios do not have a wider curriculum of 'stuff' to learn we both learn about the human body, physiology, anatomy and mechanics. Osteopaths have a 4 year MSc and contrary to some people's belief it is not all about manipulation!
Manipulation forms a part of my treatment of patients, Soft tissue massage is manipulation! Rehabilitaion of a patient requires looking at lifestyle, exercise, posture etc as well as adjusting bones and muscles.
Fancy clicks are usually just the 'icing on the cake' in a treatment the rest of the treatment is designed to do most of the work.

I would like to point out that there are awful Physio's, awful chiro's and awful osteopaths out there go on a recommendation from friend or colleague to make sure you get the right one.

I treat musculoskeletal conditions, other conditions appear to get better in the process sometimes which is great my patients love that bit!
I do not create patient reliance, I actively discourage too regular treatment.
If you really want this evidance based medicine then the UK BEAM trial showed that Osteopathy helps musculoskeletal conditions.
I prefer to rely on the fact that 93 percent of my patients get better from my treatment in a shorter period of time than they expected (and yes I did do the proper statistics on this!)
sorry for the essay!

UK BEAM trial showed that Osteopathy helps musculoskeletal conditions.

Hardly a ringing endorsement and that is the best result ever got. Quite possibly down to placebo effect.

Conclusions Relative to “best care” in general practice, manipulation followed by exercise achieved a moderate benefit at three months and a small benefit at 12 months; spinal manipulation achieved a small to moderate benefit at three months and a small benefit at 12 months; and exercise achieved a small benefit at three months but not 12 months

Most research on this shows no benefit at all.

Now I have had osteopathy and I don't make the mistake of confusing it with physio. However stating stuff the example of the horse rider above and

93 percent of my patients get better from my treatment in a shorter period of time than they expected

93 percent of my patients get better from my treatment in a shorter period of time than they expected

do you no good and destroy any claims to credibility

We are heavily regulated as a profession the general osteopathic council is there to protect patients if you have a poor treatment then complain to them Osteopaths do get struck off if they are not up to standard
Have you had a particularly bad experience of Osteopaths Tandemjeremy

TJ says earlier that hes used them to some benefit.

I think what he means is that practitioner survey based statistics really arent of much value in the clinical environment.

I havent read the papers alluded to, but Im guessing that there's very few normalised trials comparing like-for-like clinical performance of osteo versus anti-inflammatory drugs or physios or massage etc etc. And without it there's not enough to hang wider conclusions on other than that some people benefit from some elements of the treatment, but maybe not all, and not for everyone and not for all symptoms.

AS Junkyard says - I am a believer in evidence based practice. I want to see randonmised double blind studies showing benefits.

So most of your patients get better quicker than they thought they would - shows exactly nothing as to the efficacy of the treatment, it shows they are happy thats all.

Its that kind of non rigorousness analysis presented as evidence that destroys credibility.

Thats why the BEAM study is good - it is rigourous and valid. It only shows very small benefits.

TJ says earlier that hes used them to some benefit.

how does he know it was to some benefit - it could just have been a placebo effect?

It was me that mentioned to horse rider - I am not an osteo.

After tearing my L5-S1 disc playing rugby, osteopathy helped me get some quality of life back. My point is that the treatment helped. I do not care whether there is clinical proof or not.

junkyard? eh? 😉

I understand and agree with the fact there is a lack of 'Gold standard' trials out there but I feel that there needs to be something better than a double blind randomized controlled trails as this is not possible in a clinical situation as the variables that you are dealing with are vast. For a start every 'body' is different every time you see it.
I know we live in a world where 'evidence based medicine' is what we are after but the tools are not there! In absence of this I have to rely on the information I have available. No I won't help everyone but show me a drug that has come through all the double blind trials and helps everyone that uses it.

I work very hard for my patients and if they are happy with the treatment that is what I am after. If they walk out with less pain than they previously had then I feel I have done my job. If a pain they had for 2 years magically goes away after a treatment and stays gone for a further year, I feel I have done my job! silly examples I know but it's how I sleep at night!

I can recommend this as well:

[url= http://www.backstretcher.com/en/products/backstretcher ]Backstretcher[/url]

something else for TJ and SBZ to slag off, but it works well for me.

😳

precursor to the backstretcher 😉
[img] [/img]

The inventor of the backstretcher is a physiotherapist.

It works really well - the idea is that you lie on the rest and gradually relax into it, and the weight of your head will cause your back to stretch out.

A bit like what people try to achieve with inversion tables and hanging from door frames, but the premise is that you will never stretch out fully using these methods as your back muscles have to support your weight, which they do not on the backstretcher.

There are some medical reports listed on their site but I actually had a link to a paper that did a study of the amount of elongation a patient acheived through the various methods, and the backstretcher was the most effective.

No good for lower back pain though, only upper.

sorry, did someone say ...

[i]AS Junkyard says - I am a believer in evidence based practice. I want to see randonmised double blind studies showing benefits[/i]

Like this?
[url] http://www.bmj.com/content/327/7429/1459.full [/url]

Very good Ian

psychle, go and see Daniel. let me know if you need his details again. £60 to find out. And my recommendation that he's bloody good. Recommended to me by a doctor who's seen loads of speacialists in different areas. Recommended to her as the best person to see in London by a well respected Osteopath in Suffolk who runs a practice with 10 osteopaths.

AS Junkyard says - I am a believer in evidence based practice. I want to see randonmised double blind studies showing benefits

Like this?
http://www.bmj.com/content/327/7429/1459.full

Love it!

As I have said use a recommendation of an osteopath from a friend/colleague and you shouldn't be disappointed by the outcome!
So perhaps use [i]nedrapier[/i] referral or let me know where you are based and I can recommend someone who is respected in the profession. Good luck in your journey to health I hope my profession stands up to your scrutiny!! ([i]sits biting nails nervously!![/i])

LOL @ Ian's link.

Cheers for all the discussion chaps, appreciated. I guess I was a bit worried (after a bit of googling) that Osteopathy was a somewhat like Bowen Technique (which I tried ages ago but found just to 'wishy washy' for me!), hence the question as to it's legitimacy...

I really want a good solid physical therapy that looks at all the aches and pains I have (and there's a few!) and hopefully finds a 'whole body' type solution/treatment - physio is good, but I've always found that it treats only one thing at a time, rather than looking at the bigger picture (could be that I've had the wrong Physiotherapist of course).

Anyhoo, shall give Daniel a call and see how we go (Ned, is he based near Sloane Square btw?)

yup. ygm avec directions.

I have been to Osteo for a few injuries, back injuries/treatment I think they are very good, anything outwith spine, lower back I would go to physio.

I did go to Chiropractor for a back issue, never again (although I believe some people think they are good, I just dont.)